A 2-year-old girl presented with a 4-month history of a slightly pruritic eruption, which was limited to the left side of her body including the leg and trunk. The lesions were erythematous papules and vesicles that were distributed linearly along the Blaschko’s lines (Fig. 1). Except for the skin lesions, there were no remarkable findings on physical examination. There was no personal or family history of atopic disorders, psoriasis or any other type of dermatitis or viral infection. She had been treated with topical corticosteroid therapy at a local clinic for three months with little improvement.

Fig. 1. A, B, C. Erythematous discrete

Fig. 1. A, B, C. Erythematous discrete grouped papules and vesicles on the left side of the leg and flank along the Blaschko line.

A biopsy specimen from a lesion on her left leg demonstrated mild hyperkeratosis of the epidermis with perivascular lymphohistiocytes infiltration and mild telangiectasis in the papillary dermis. A closer view revealed exocytosis, spongiosis and focal vacuolar degeneration of the basal cell layer in the epidermis (Fig. 2).
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Fig. 2. Mild hyperkeratosis

Fig. 2. Mild hyperkeratosis of the epidermis with perivascular lymphohistiocytes infiltration and mild telangiectasis in the papillary dermis. It showed exocytosis, spongiosis and vacuolar degeneration of the basal cell layer in the epidermis (H&E, x 200).

The eruption did not respond to methylpredni- solone acetonate 0.1% ointment that had been topically applied for one month. Therefore, systemic therapy was introduced with oral prednisolone 5 mg per day. Significant improvement was noted after 10 days but the lesion recurred 1 month later after the cessation of systemic therapy.  viagra soft